India has registered a 26.9 per cent reduction in Maternal Mortality Ratio (MMR) since 2013, according to the Sample Registration System (SRS) bulletin 2016 released on November 7.

The decline in MMR has been from 77 to 72 per 100,000 live births among southern states and in the other states, from 93 to 90, it stated.   

The ratio has declined from 167 in 2011-13 to 130 in 2014-16 and to 122 in 2015-17, registering a 6.15 per cent reduction since the last survey figures of 2014-16, according to the special bulletin of the Office of the Registrar General.

To understand the maternal mortality situation in the country better and to map the changes that have taken place, especially at the regional level, the government has categorised states into three groups - empowered action group (EAG) states, southern states and other states.

EAG states comprise Bihar, Jharkhand, Madhya Pradesh, Chhattisgarh, Odisha, Rajasthan, Uttar Pradesh, Uttarakhand and Assam. The southern states are Andhra Pradesh, Telangana, Karnataka, Kerala and Tamil Nadu and the other states cover the remaining states and Union Territories.

“It is heartening that the maternal mortality ratio has declined from 130 in 2014-16 to 122 in 2015-17. The decline has been most significant in empowered action group (EAG) states and Assam from 188 to 175,” it said.

Kerala, Maharashtra and Tamil Nadu have already met the sustainable development goals target of 70 per 100,000 MMR, while Andhra Pradesh and Telangana are within “striking distance”, a health ministry official said.

Maternal deaths being a rare event require a large sample size to provide robust estimates. In order to enhance the SRS sample size, the results were derived by following the practice of pooling three years’ data to yield reliable estimates of maternal mortality, the bulletin stated.

The first report on maternal mortality in India (1997-2003), describing trends, causes and risk factors, was released in October 2006.

The WHO last year lauded India’s progress in reducing the MMR saying the progress puts the country on track towards achieving the Sustainable Development Goal (SDG) target of an MMR below 70 by 2030.

What is SRS?

The Sample Registration System (SRS) is a large-scale demographic survey for providing

reliable annual estimates of infant mortality rate, birth rate, death rate and other fertility and mortality indicators at the national and subnational levels.

Initiated on a pilot basis by the Office of the Registrar General in a few selected states in 1964-65, it became fully operational during 1969-70 with about 3,700 sample units.

The field investigation consists of continuous enumeration of births and deaths in selected sample units by resident part-time enumerators, generally anganwadi workers and teachers, and an independent survey every six months by SRS supervisors.

The data obtained by these two independent functionaries are matched. The unmatched and partially matched events are re-verified in the field and thereafter an unduplicated count of births and deaths is obtained.

The sample unit in rural areas is a village or a segment of it (if the village population is 2,000 or more). In urban areas, the sampling unit is a census enumeration block with population ranging from 750 to 1,000. The SRS sample is replaced every 10 years based on the latest census frame. The current sample is based on the 2011 Census frame.

At present, SRS is operational in 8,850 sample units (4,961 rural and 3,889 urban) covering about 7.9 million population, spread across all states and Union Territories.

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